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For Freudian theory, the investigatory stance concerned the analyst’s adherence to a posture of neutrality and abstinence. Neutrality meant remaining opaque to the patient, offering little response to the patient. The analyst was expected to function like a projective screen onto which the patient displaced or projected his inner wishes and conflicts. This was the transference—the patient’s distorted perception of the analyst in the present in terms of a significant relationship from his past. This formative relationship was thought to be a contributor to the patient’s inner conflicts. By maintaining a stance of neutrality, the transference could be preserved from contamination by the actuality of the person of the analyst and, thereby, could be pointed out as a distortion residing solely in the mind of the patient. Any feelings the patient had for the analyst were thought to emanate from distortions due to displacements or projections from the inner world of the patient and had nothing to do with the actual person of the analyst. For example, if the analyst communicated to the patient her personal feelings of care and concern for him, this would contaminate the transference. Since any future feelings the patient experienced for his analyst might have been instigated by the analyst’s actions, the patient’s feelings could not be attributable solely to transference, to the reappearance of feelings from his childhood being displaced onto the present.

Through the use of such techniques as having the patient recline on a couch, the analyst sitting out of sight and maintaining a stance of abstinence (not gratifying the transference wishes), and meeting at least four times a week, regression (a resurgence of ways of coping and experiencing from childhood) was promoted. This fostered the formation of a transference neurosis in the present. The transference neurosis represented a revival in the present relationship with the analyst of the original childhood neurosis. By resurrecting the original childhood neurosis in the transference, the analyst was able to gain access to the patient’s past. Resolving the current transference neurosis, through insight gained from the analyst’s interpretations, was thought to mitigate the original childhood neurosis.

Another important component of the Freudian investigatory stance was the notion that buried memories of childhood wishes and conflicts could be uncovered, brought to light, and made conscious by putting them into words. Thus, the emphasis was placed on the analyst’s verbal interpretations, primarily of the transference, and on the accuracy and timing of these interpretations. The analyst’s verbal interpretations, explanations of the underlying meaning of the patient’s behavior or fantasies, promoted insight. And insight and understanding strengthened and extended the ego’s dominion over the drives and the superego.

This abbreviated review of the Freudian investigatory stance enables us to highlight how the Freudian techniques of treatment follow quite logically from the underlying assumptions of Freudian theory. That is, the Freudian view was that current neuroses were the outgrowth of repressed childhood conflicts. Observing analytic neutrality and abstinence and promoting regression would resurrect those forgotten childhood conflicts in the present transference to the analyst. These pathogenic childhood conflicts could then be interpreted and made conscious. In a similar manner, the investigatory stance of the intersubjective approach to treatment grows out of its assumptions about the nature of psychological development.

Let us review some of the assumptions underlying the intersubjective approach and examine their influence on the investigatory stance. First is the assumption that human beings, by nature, organize experience, and the need to maintain this organization of experience is a crucial motive in behavior. This supraordinate motivational principle profoundly affects the investigatory stance that characterizes the intersubjective approach to treatment and differentiates it from other therapeutic systems. Rather than listening for derivatives of repressed impulse, defense, or conflict, the intersubjective therapist’s focus is directed toward discerning those principles, generally unconscious, and the accompanying disruptive affect states, that organize the patient’s experience. In addition, the therapist strives to appreciate that much of what gets labeled as psychopathology represents attempts on the part of patients to maintain or restore their threatened sense of psychological equilibrium. Symptomatic behaviors, whether constructed out of concretizations, dissociations, or other psychological processes, are understood to serve the crucial psychological purpose of maintaining or restoring the organization of experience. They are dramatic manifestations of the patient’s striving for psychological integrity, not compromise formations that attempt to garner disguised or distorted satisfactions. Therefore, an important emphasis of the intersubjective approach is the focus on the patient’s striving for psychological health rather than on the patient’s psychopathology, his propensity to repeat earlier maladaptive patterns. This, as we will see, has profound implications for the practice of psychotherapy. For example, a patient who tolerates an abusive relationship might be characterized as masochistic. That is, traditionally, he may have been viewed as seeking out or needing to repeat hurtful experiences, perhaps because of the disguised sexual pleasure derived or out of an unconscious wish to be punished for guilt-laden desires. An alternative explanation that focuses on the patient’s striving to maintain a precarious sense of self-cohesion might be that enduring the abusive experiences, rather than repeating, seeking, or desiring them, is the price the patient is willing to pay for maintaining a relationship that in other ways is experienced as self-sustaining. Possible organizations of experience underlying this patient’s sense of himself in an abusive relationship might be that he does not deserve to be treated otherwise or that he will never have a different kind of relationship or that he could not survive without a partner, so he must settle for this current one.

As a corollary to the assumption that humans organize their experiences into patterns and expectancies, a further assumption of intersubjectivity theory is that human beings are motivated to seek out those relational experiences that will promote and enhance self-development. If an adult regulates and integrates discrepant affect states, maintains a consistent sense of self over time, and enjoys positive self-esteem, we speak of someone who has achieved a measure of self-cohesion. Those relational experiences that promote or enhance self-cohesion and the integration of affect are referred to as selfobject experiences (we will have more to say about selfobject experience in chapter 5).

Central to the investigatory stance of intersubjectivity theory is the empathic-introspective mode of inquiry. Historically, Kohut first introduced his formulation of the empathic-introspective mode of inquiry in 1959. According to Kohut (1984), “The best definition of empathy . . . is that it is the capacity to think and feel oneself into the inner life of another person” (p. 82). Since then, there has been a tendency in the self-psychology literature to use the notion of empathy in two different ways. In the first case, empathy has been used to describe a way of responding with care and concern to another, as in, “John empathized with Mary.” The other usage of the term empathy is as a listening stance adopted by the therapist. Stolorow and colleagues (1987) have proposed that reserving the term empathy for referring only to the listening stance could reduce the potential for confusion that results from the two different usages and meanings of the term. In intersubjectivity theory, then, empathy refers to a method for learning about the patient’s subjective experience, and empathic listening refers to the therapist’s attempt to understand the patient’s experience, to the extent that one can ever fully grasp another’s experience. Stolorow and colleagues propose that we use the concept of affect attunement to describe the therapist’s responses to the patient’s experience. For example, when the therapist says, “It sounds like you felt hurt when your father forgot your birthday,” the therapist is communicating her understanding of the patient’s affect state and, by doing so, providing the patient with the experience of feeling understood, or attuned to. Thus, the therapist’s affect attunement promotes the patient’s integration of affect (“I did feel hurt”) and is clearly a vital selfobject function. The empathic stance is the therapist’s attempt to approximate the patient’s inner experience and, from that perspective, respond in a way that the patient experiences as attuned.

Since the intersubjective approach focuses on the field created by the coming together of subjectivities of both patient and therapist, the “introspective” component of the empathic-introspective stance concerns the manner by which the therapist attunes to her own internal processes. The importance of the therapist’s introspective focus is on gaining and maintaining an awareness of the impact the therapist’s person is having on the patient. In other relational approaches to psychotherapy, the therapist prizes her awareness of her experience, her countertransference, for what it tells the therapist about the patient’s motives. In the intersubjective approach, the introspective stance is valued for two reasons: first, for what it reveals of the therapist’s impact on and contribution to the patient’s experience and, second, for providing the therapist with an emotional or experiential analogue that will both facilitate access to what that patient is feeling and be a basis for responding in an attuned way. Consider, for example, the situation of a patient who does not show up for his session and neglects to inform the therapist in advance. Attuning to her experience of irritation and annoyance, the therapist might interpret the patient’s unconscious passive-aggressive desires to hurt the therapist or, for those therapists with a more Kleinian bent, the patient’s unconscious desire to make his therapist feel the way he felt when his parents forgot to pick him up after school and left him stranded. Rather than assume that the therapist’s experience derives from the patient’s angry motives, the intersubjective approach would lead the therapist to examine her own experience of the previous session (introspection) and explore the patient’s experience of the therapist during the previous session. Might the patient’s absence have been instigated by some experience of the therapist, such as the patient feeling hurt or injured by the therapist? This is not to suggest that anger might not be a reactive piece of the patient’s experience, but it allows for the focus to be directed to the intersubjective field constructed of the experiences of both patient and therapist to the previous session.

The above example highlights the importance of context for the intersubjective approach. For the Freudian system, the investigatory stance aims at uncovering the intrapsychic world of the patient. The aim of psychotherapy from the intersubjective perspective is to illuminate the contextual basis of experience, the patient’s and the therapist’s.